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New Hampshire rates for HCPCS J3260

Injection Tobramycin Sulfate Up To 80 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.37 / $2.46 / $187.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.83 / $3.56 / $9.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.37 / $2.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $2.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.22 / $3.95 / $7.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $2.37 / $5.69
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.78 / $3.83